EFFECT OF DEEP INJECTIONS OF LOCAL-ANESTHETICS AND BASAL DILATATION OF CERVIX IN MANAGEMENT OF PAIN DURING LEGAL ABORTIONS - A RANDOMIZED, CONTROLLED-STUDY

The present study was designed to investigate whether deep injections of local anesthetics provide better pain control than regular injectio ns of local anesthetics, and to evaluate the influence of basal cervic al dilatation and dilatation increase obtained on the painfulness of a bortion procedure during legal abortions. A total of 66 women undergoi ng legal abortion were randomly allocated to treatment with deep injec tion (n = 31) or regular injection (n = 35) group. Subjects in the dee p injection group had paracervical block involving four injections app roximately 3 cm deep. Subjects assigned to the regular injection group had paracervical block involving four injections approximately 1.5 cm deep. A pain scale was administered at the end of the dilatation and end of curettage. Both groups were found to be similar with respect to age, parity, previous legal abortion, gestational age, anxiety score, procedure time, basal cervical dilatation, and dilatation increase ob tained. The mean pain score during cervical dilatation was less for th e deep injection versus the regular injection group (3.3 +/- 1.5 versu s 4.0 +/- 1.6, p <0.05). The mean pain score during curettage was sign ificantly less for the deep injection versus the regular injection gro up (3.0 +/- 1.2 versus 3.9 +/- 1.4, p <0.05). In conclusion, deep inje ction of local anesthetics is a safe adjunct in the management of lega l abortion. Irrespective of injection technique, dilatation pain is co rrelated negatively with basal cervical dilatation and correlated posi tively with dilatation increase obtained. (C) 1997 Elsevier Science In c. All rights reserved.